Promoting Interoperability: What’s in a Name?

Time truly flies when you are having fun. Can you believe tomorrow is May 1? I am amazed how quickly this year is passing by. In an otherwise quiet week at the intersection of nephrology and health IT, our good friends at the agency decided it was time to shake things up a bit by changing the Meaningful Use moniker—again. That’s right folks, Meaningful Use will no longer be referred to as Advancing Care Information. (Thank God.) The new name is “Promoting Interoperability.”

This little tidbit emerged with last week’s publication of the 1,900 page tome entitled “Fiscal Year (FY) 2019 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Proposed Rule, and Request for Information.” Talk about a mouthful! Many of us in the nephrology space have made the jump to MIPS and Advancing Care Information, and sometimes we forget that every hospital in the country continues to chase Meaningful Use. The mouthful above is basically the annual proposed rule regarding changes that hospitals must pay attention to.

MyHealthEData

The name change comes on the heels of the CMS announcement at HIMSS of an initiative cleverly named “MyHealthEData.” Get it? The stated goal is to put the patient in control of their data and create transparency that permits patients to make more informed healthcare decisions. The Medicare Blue Button upgrade will reportedly play a role with the release of Blue Button 2.0 in the not too distant future.

In addition to the name change, the proposed rule intends to overhaul the legacy MU program with following goals in mind:

Make the program more flexible and less burdensome

Emphasize measures that require the exchange of health information between providers and patients

Incentivize providers to make it easier for patients to obtain their medical records electronically

While this proposed rule is laser focused on the inpatient EHR space, the name change will apply to both the inpatient EHR incentive program (currently known as Meaningful Use) and to the Advancing Care Information section of MIPS. Beyond the name change we will certainly keep our eyes open for the parallel changes to the physician-facing EHR program which will likely emerge when the dust settles on the inpatient side of the house.

PI

Shortly after the name change was announced last week, my colleague Diana Strubler promptly noted we would soon be shortening Promoting Interoperability to simply “PI”. Diana raised the question of confounders and highlighted a few possible competing terms to be aware of.

Other things that use PI for short:

Poison Ivy

Pain Intensity

Prison Industry

Paranoid Ideation

Personal Injury

Private Investigator

Purposeful Interference

Prescribing Information

I’d like to add one more to the mix: the ratio of a circle’s circumference to its diameter, or π. Pi is attractive for several reasons—it’s related to circles (as in running in circles) and it’s an irrational number. 3.1415926535 just keeps going forever!

The Holy Grail

Interoperability is a frequent topic in the Acumen blog. In my view, it was one of the foundational goals driving the adoption of electronic health records. We have made some progress since 2011, the first payment year for the meaningful use program. But the promise of interoperability remains unfulfilled. Substantial work lies ahead, and it will take much more than a simple name change to reach the promised land. CMS Administrator Seema Verma appears ready to make the necessary commitments. She was recently quoted as saying:

“There has been a lot of work done in terms of making sure providers are using electronic health records, and that’s great. But EHR adoption has also created electronic siloes. We had filing cabinets before—now we have these electronic siloes. Data doesn’t mean anything unless it’s put into a format that is meaningful to the end user, whether that’s a provider or a patient. That is where we will be continuing to focus our efforts going forward.”

Let’s hope she means it.

What are your thoughts about MU’s new name? Drop us a comment and join the conversation.

Terry Ketchersid, MD, MBA, practiced nephrology for 15 years before spending the past seven years at Acumen focused on the Health IT needs of nephrologists. He currently holds the position of Chief Medical Officer for the Integrated Care Group at Fresenius Medical Care North America where he leverages his passion for Health IT to problem solve the coordination of care for the complex patient population served by the enterprise.